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Courtney Jones, regional pharmacy manager with Tops Markets, holds the package for the quadrivalent influenza vaccine, which has become the most common flu vaccine for those aged 6 months to 65 years old. Tops pharmacies also are among those which have high-dose vaccines recommended for those over 65, Jones said. (Robert Kirkham/Buffalo News)

FAQ: National and local experts on why you should get a flu shot

Answers were provided by the federal Centers for Disease Control and Prevention; Dr. Thomas Russo, professor and chief of infectious diseases in the University at Buffalo Jacobs School of Medicine and Biomedical Sciences; Dr. Richard Vienne, Univera Healthcare vice president and chief medical officer; and Courtney Jones, who holds a doctorate in pharmacy and is a regional pharmacy manager with Tops Markets.

Q: Who should get the flu shot?

Almost everyone 6 months and older who hasn't had a serious reaction to a flu shot in the past, and who isn't currently sick or undergoing treatment for cancer or other serious illnesses. If people have any concerns or questions, they should first check with their primary care provider. “For children under 5, those who are pregnant, adults over 65, and patients in nursing homes and long-term care facilities, it's especially important," Jones said.

Q: What does the flu shot cost?

It’s covered by almost all health insurance, without a copay.

Q: I eat right, exercise and am very healthy. Why should I bother with the flu shot?

The flu can bring down even the healthiest among us, taking us to bed for up to a week with symptoms that include fever, fatigue, body aches, chills, dehydration, congestion, runny nose, sneezing, nausea, shortness of breath and sore throat. In severe cases, it can lead to pneumonia, other respiratory illness and death. It’s also very contagious. A flu virus can spread up to 6 feet from microscopic droplets that come with a cough, sneeze or simple conversation, Vienne said, and once someone contracts a virus, that person can spread it – easily – for a day before any symptoms appear, endangering others.

Q: Can you get the flu from the flu shot?

The only vaccine to contain live influenza virus – in weakened form – is the nasal vaccine, which is recommended this flu season for those age 2 to 49 with a deep aversion to needles who otherwise would go without one. It’s possible, but very unlikely, to contract the flu from this vaccine, Russo said. All other forms of the vaccine contain three or four inactive (dead) strains of the flu virus (trivalent, quadrivalent).

The aim of each vaccine is to create an immune response in the body during a single flu season to attack up to four strains of the flu – and provide at least some protection against other flu strains and subtypes like them. Seasonal flu vaccines are most effective only against the strains in the vaccine, which change from year to year based on past flu seasons, the most recent flu viruses that showed up in the Southern Hemisphere and scientific predictions. Another challenge: Many viruses aside from flu bugs bring on similar symptoms – which also helps explains the phrase “I get a flu shot and then I got the flu.”

The CDC conducts studies each year to determine vaccine protectiveness, and it can vary. Recent studies show that that vaccination reduces the risk by 40 percent to 60 percent overall when the viruses contained in the vaccine match those circulating among people. The Influenza A virus has 29 subtypes; Influenza B has no subtypes but can be broken down into several lineages and subtypes. Public health researchers use randomized studies of a group of people who got vaccinated and got the flu and compare that group to unvaccinated and placebo groups.

Q: At those effectiveness rates, why bother to get a flu shot?

Because of the large number of related deaths and illnesses caused by the flu. Several studies also have shown that flu shots reduce the length and severity of illness in those who get vaccinated but still get sick.

Q:What factors influence how well the vaccine works?

How well the vaccine matches the strains that emerge from season to season, as well as the general health of the person getting the vaccine, are key.

“A 2014 study showed that the flu vaccine reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74 percent during flu seasons from 2010-2012,” according to the CDC. Several studies have shown the vaccine works best when children advised to get two doses during the first season they are immunized do so.

“A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent,” the CDC reports. Other studies have shown reduced hospitalizations among those with diabetes and chronic lung disease.

Q: What are the risks?

""Whenever you take any medication, there's a small but finite chance you can have an adverse reaction to it, but it's very rare with the flu vaccine," says Dr. Thomas Russo, professor and chief of infectious diseases in the University at Buffalo Jacobs School of Medicine & Biomedical Sciences. (UB photo/Special to the News)

Minor problems, which are uncommon, can include temporary soreness or swelling in the injection area, hoarseness, cough, fever, achiness, headache, fever, itching or fatigue, and sore, red or itchy eyes. Allergic reactions, though rare, are possible and studies suggest there may be a small increased risk of Gullain-Barre Syndrome, a neurological disorder which results in muscle weakness. These risks are much smaller than the severe complications that can come with the flu.

A National Vaccine Injury Compensation Program allows those with adverse reactions to vaccines, including the flu shot, to file a petition for compensation. According to the CDC, more than 3.1 billion doses of covered vaccines were distributed across the country from 2006 to 2016. There were 5,544 petitions handled during that time; 3,758 were compensated. “This means for every 1 million doses of vaccine that were distributed, one individual was compensated,” according to federal officials.

"Whenever you take any medication, there's a small but finite chance you can have an adverse reaction to it,” Russo said, “but it's very rare with the flu vaccine."

Q: Should pregnant women get the vaccine?

Vaccination helps protect women during and after pregnancy, the CDC says. For pregnant women, it cuts by half the risk of flu-associated acute respiratory infection and lowers the risk of being hospitalized with flu by an average of 40 percent. Getting vaccinated also can protect a baby from flu during the first six months of life, when flu vaccines are not recommended.

The Autistic Self Advocacy Network lamented in 2015 that this long-discredited claim continues to arise. The impact of such “pseudo-scientific causation myths … suggest that exposing children to deadly diseases would be a better outcome than an autistic child,” the network said in a statement that year.

The mercury-based preservative thimerosal has come under the greatest criticism among those who continue to fear ties with autism. “Between 1999 and 2001, thimerosal was removed or reduced to trace amounts in all childhood vaccines except for some flu vaccines,” according to the CDC. “Currently, the only childhood vaccines that contain thimerosal are flu vaccines packaged in multidose vials. Thimerosal-free alternatives are also available for flu vaccine.” Jones said Tops pharmacies are among those who only use single-dose packaging, without preservatives, for flu shots.

Q: Besides vaccination, how can people protect themselves against the flu?

“Getting a flu vaccine each year is the best way to prevent the flu,” according to the CDC. Other ways include covering coughs, washing hands often, and avoiding people who are sick.

Phyllis Burgio, a Clarence chiropractor, maintains that regular exercise, a healthy diet and normal weight are the best ways for the body’s immune system to effectively fight the flu, as well as other illness and disease. “Our body has its own built-in pharmacy. It can handle a bacteria. It can handle a virus. When a body is exposed to something like that ... its natural physiology is to get rid of it faster [through vomiting, diarrhea and coughing, for instance] to restore itself to health.”

“Antiviral drugs are an important second line of defense to treat the flu,” the CDC says. Medications – including oseltamivir (Tamiflu) and a new drug called baloxavir marboxil (Xofluza) – can decrease flu symptoms by one or two days if administered within 48 hours of influenza onset. Xofluza need only be taken once instead of over five days as with Tamiflu, Russo said, and is effective against less common strains including the so-called Bird Flu. "It's very nice to have this additional drug but it is no substitute for vaccination,” the UB infectious disease specialist said, “and people with severe influenza illness often present too late for these drugs to really have a clear effect."

For answers to more questions in greater detail, including a report from the CDC on this flu season, click here.

Scott Scanlon – Scott Scanlon, an award-winning reporter, is editor of WNY Refresh, which focuses on health, fitness, nutrition and family matters. A Western New York native, he is a graduate of the University at Buffalo and received his master's in history from Binghamton University.